收稿日期: 2023-11-09
网络出版日期: 2024-05-21
基金资助
河北省专科能力建设和专科带头人培养项目(LS201804)
Quantitative CT evaluation for thoracic vertebral bone density and age⁃related bone loss
Received date: 2023-11-09
Online published: 2024-05-21
目的 探讨胸椎定量CT（QCT）测量骨密度及骨丢失率的可行性。 方法 选取因健康体检及急腹症行全腹部CT扫描的患者708例，使用QCT软件测量T10 - L3椎体骨密度。将受检者按每10岁为一个年龄段分组。计算每个年龄组的胸椎及腰椎骨密度，并计算各组别的峰值骨密度及骨丢失率。胸椎与腰椎骨密度及其与年龄的相关性采用Pearson相关分析。 结果 男性、女性骨密度峰值均在20 ~ 29岁年龄组，30岁以后胸腰椎骨密度开始不同程度减低，80 ~ 89岁女性胸椎及腰椎累计骨丢失率分别为60.61%及61.34%，而男性分别为44.45%及49.35%。男性与女性胸腰椎骨密度均与年龄呈负相关（P < 0.01）。胸椎与腰椎骨密度呈正相关（男性r = 0.96、女性r = 0.98，P < 0.01）。 结论 胸椎及腰椎QCT均能准确地显示不同年龄组的骨密度及骨丢失情况，胸椎QCT可以作为评价和监测骨丢失的一种方法。
关键词： 骨丢失; 骨密度; 体层摄影术，X线计算机; 定量CT; 胸椎
赵君禄 , 刘斋 , 赵德园 , 聂关伟 , 任庆云 . 定量CT评价胸椎骨密度及与年龄相关的骨丢失[J]. 实用医学杂志, 2024 , 40(10) : 1429 -1433 . DOI: 10.3969/j.issn.1006-5725.2024.10.017
Objective To compare the bone mineral density and age?related bone loss rate of thoracic and lumbar vertebrae using quantitative CT（QCT）， and to explore the feasibility of measuring bone density and bone loss rate using thoracic QCT. Methods A total of 708 patients who underwent full abdominal CT scans due to trauma， acute abdominal disease， and health examination from March 2022 to March 2023 were selected. The average BMD of T10 to L3 vertebral bodies were measured using quantitative CT software. The subjects were divided into several age groups according to the age of every 10 years. The average bone density and the age?related annual rate of bone density loss of the thoracic and lumbar vertebrae for each group were computed， the correlation analysis between thoracic and lumbar BMD and age was conducted using Pearson correlation analysis. Results The peak BMD for both males and females was in the 20 to 29 years age group. After the age of 30， the bone density of the thoracic and lumbar vertebrae began to decrease to varying degrees. For females aged 80 to 89， the cumulative bone loss rate for the thoracic and lumbar vertebrae was 60.61% and 61.34%， respectively， while for males， it was 44.45% and 49.35%， respectively. The BMD of the thoracic and lumbar vertebrae in both males and females showed a negative correlation with age （P < 0.01）. There was a significant positive correlation between the bone mineral density of the thoracic and lumbar vertebrae （for males， r = 0.96； for females， r = 0.98； P < 0.01）. Conclusion Both thoracic and lumbar QCT accurately displayed BMD and bone loss in different age groups， and thoracic QCT could be used as a method for evaluating and monitoring bone loss.
| 1 | OKANO I， JONES C， SALZMANN S N， et al. Postoperative decrease of regional volumetric bone mineral density measured by quantitative computed tomography after lumbar fusion surgery in adjacent vertebrae［J］. Osteoporos Int， 2020，31（6）：1163-1171. doi:10.1007/s00198-020-05367-3 |
| 2 | 李娜，唐海，张勇，等. 双能X线吸收与定量CT对比评价北京地区中老年女性与年龄相关的骨丢失［J］. 中国医学影像技术， 2015，31（10）：1487-1491. |
| 3 | LIN W， HE C， XIE F， et al. Discordance in lumbar bone mineral density measurements by quantitative computed tomography and dual-energy X-ray absorptiometry in postmenopausal women： a prospective comparative study［J］. Spine J， 2023，23（2）：295-304. doi:10.1016/j.spinee.2022.10.014 |
| 4 | BOEHM E， KRAFT E， BIEBL J T， et al. Quantitative computed tomography has higher sensitivity detecting critical bone mineral density compared to dual-energy X-ray absorptiometry in postmenopausal women and elderly men with osteoporotic fractures： a real-life study［J］. Arch Orthop Trauma Surg， 2024，144（1）：179-188. doi:10.1007/s00402-023-05070-y |
| 5 | CHENEYMANN A， THERKILDSEN J， WINTHER S， et al. Bone mineral density derived from cardiac CT scans： Using contrast enhanced scans for opportunistic screening［J］. J Clin Densitom， 2023，27（1）：101441. doi:10.1016/j.jocd.2023.101441 |
| 6 | 张羽，张宗军，刘许慧，等. 胸椎定量CT和腰椎双能X线吸收检测仪对绝经后女性骨质疏松症的诊断差异［J］. 放射学实践， 2022，37（10）：1205-1210. |
| 7 | 胥晓明，王玲，蒋雯，等. 美国放射学院、儿科放射学会和骨骼放射学会关于定量CT扫描应用指南（2018 版）解读［J］. 中华放射学杂志， 2020，54（8）：745-751. |
| 8 | 蹇新梅，宋玲玲，杜霞，等. 定量CT（QCT）测定健康体检者胸腰椎骨密度分布规律及其相关性［J］. 中国骨质疏松杂志，2021，27（10）：1499-1502. doi:10.3969/j.issn.1006-7108.2021.10.018 |
| 9 | SHEPHERD J A， BAIM S， BILEZIKIAN J P， et al. Executive summary of the 2013 International Society for Clinical Densitometry Position Development Conference on Body Composition［J］. J Clin Densitom， 2013，16（4）：489-495. doi:10.1016/j.jocd.2013.08.005 |
| 10 | SALZMANN S N， OKANO I， JONES C， et al. Thoracic bone mineral density measured by quantitative computed tomography in patients undergoing spine surgery［J］. Spine J， 2021，21（11）：1866-1872. doi:10.1016/j.spinee.2021.05.016 |
| 11 | MAO S S， LI D， SYED Y S， et al. Thoracic Quantitative Computed Tomography （QCT） Can Sensitively Monitor Bone Mineral Metabolism： Comparison of Thoracic QCT vs Lumbar QCT and Dual-energy X-ray Absorptiometry in Detection of Age-relative Change in Bone Mineral Density［J］. Acad Radiol， 2017，24（12）：1582-1587. doi:10.1016/j.acra.2017.06.013 |
| 12 | LIAO E Y， WU X P， DENG X G， et al. Age-related bone mineral density， accumulated bone loss rate and prevalence of osteoporosis at multiple skeletal sites in chinese women［J］. Osteoporos Int，2 002，13（8）：669-676. doi:10.1007/s001980200091 |
| 13 | 金鹰，赵凯平，瞿建，等. 基于定量CT的中国健康成年女性腰椎骨密度正常参考值及地区差异［J］. 中华健康管理学杂志，2022，16（9）： 610-615. doi:10.3760/cma.j.cn115624-20220321-00186 |
| 14 | OUYANG Y， QUAN Y， GUO C， et al. Saturation Effect of Body Mass Index on Bone Mineral Density in Adolescents of Different Ages： A Population-Based Study［J］. Front Endocrinol （Lausanne）， 2022，13：922903. doi:10.3389/fendo.2022.922903 |
| 15 | BUDOFF M J， HAMIRANI Y S， GAO Y L， et al. Measurement of thoracic bone mineral density with quantitative CT［J］. Radiology， 2010，257（2）：434-440. doi:10.1148/radiol.10100132 |
| 16 | XUE S， KEMAL O， LU M， et al. Age at attainment of peak bone mineral density and its associated factors： The National Health and Nutrition Examination Survey 2005-2014［J］. Bone， 2020，131：115163. doi:10.1016/j.bone.2019.115163 |
| 17 | AMBROSIO M R， ALIBERTI L， GAGLIARDI I，et al. Bone health in adolescence［J］. Minerva Obstet Gynecol， 2021，73（6）：662-677. doi:10.23736/s2724-606x.20.04713-9 |
| 18 | 蒋新新，钱伟军，李立. 中老年人群中不同胸腰椎骨密度的定量CT分析［J］. 中国CT和MRI杂志， 2022，20（5）：179-182. |
| 19 | COMPSTON J E， MCCLUNG M R， LESLIE W D. Osteoporosis［J］. Lancet， 2019， 393（10169）：364-376. doi:10.1016/s0140-6736(18)32112-3 |
| 20 | Expert Panel on Musculoskeletal Imaging， YU J S， KRISHNA N G，et al. ACR Appropriateness Criteria? Osteoporosis and Bone Mineral Density： 2022 Update［J］. J Am Coll Radiol， 2022，19（11S）：S417-S432. doi:10.1016/j.jacr.2022.09.007 |
| 21 | 程晓光，李永丽，郭智萍. 低剂量胸部CT结合定量CT在健康管理的应用［J］. 中华健康管理学杂志， 2022，16（9）：593-595. doi:10.3760/cma.j.cn115624-20211219-00776 |
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